Indications, evaluation, complications, and results of functional endoscopic sinus surgery in 200 patients.

Functional endoscopic sinus surgery (FESS) is a new and exciting treatment for chronic sinus disease. Our knowledge of the surgery continues to expand. A retrospective and prospective review of 200 patients undergoing FESS was undertaken at the Houston Ear, Nose, and Throat Clinic. Parameters studied included patient symptoms, medical history, medical therapy, and radiologic findings. Also reviewed were length of hospitalization, complications, and postoperative symptoms. Nasal obstruction was the most common preoperative symptom. Anterior ethmoid and ostiomeatal complex disease were the most common preoperative CT scan findings. More than 84% of the surgeries were performed on an outpatient basis. Minor complications developed in 8% of the patients, and only one major complication occurred (0.05%). With a mean followup of 17 months, 88% of the patients were symptom-free or improved; however, 41.5% still required some medical therapy. FESS can safely be performed while the patient is under general anesthesia. Partial middle turbinectomy is a safe and recommended procedure; no cases of atrophic rhinitis occurred. We conclude that FESS is a highly successful treatment for chronic sinus disease (p < 0.01) and that a strong patient history for sinus symptoms is the most important indication for FESS.